影响高龄老年人氮末端脑利钠肽前体水平的相关因素分析  

Analysis of correlation factors on contribution to affect N-terminal pro-B-type natriuretic peptide level in the very elderly people

作　　者：朱启伟[1] 骆雷鸣[1] 叶平[1] 高鹏[1] 王浩[1] 张今尧[1] 曹瑞华[1] 

机构地区：[1]解放军总医院南楼心血管内二科,北京100853

出　　处：《中华临床医师杂志（电子版）》2013年第8期33-36,共4页Chinese Journal of Clinicians(Electronic Edition)

基　　金：中央保健专项基金科研课题(B2009B108)

摘　　要：目的探讨影响高龄老年人(年龄≥80岁)氮末端脑利钠肽前体(NT-proBNP)水平的相关因素。方法纳入2007年11月至2010年10月在解放军总医院老年病房住院,除外急性心功能不全,6个月内有急性心肌梗死、行冠状动脉旁路移植术或经皮冠状动脉成形术等病史的高龄(年龄≥80岁)老年患者共856例。测量身高、体重,采集病史;查血常规、血生化、NT-proBNP水平;完善超声心动图检查。结果 (1)NT-proBNP水平与慢性肾功能不全(β=0.290,P=0.000)、慢性心功能不全(β=0.321,P=0.000)、高血压(β=0.119,P=0.004)、房颤(β=0.358,P=0.000)、起搏器植入(β=0.231,P=0.001)、脑梗死(β=0.088,P=0.014)、感染(β=0.285,P=0.000)及血红蛋白(β=-0.007,P=0.004)等临床因素显著相关;(2)NT-proBNP与年龄(β=0.018,P=0.000)、BMI(β=-0.026,P=0.000)等非疾病因素相关,校正慢性肾功能不全、慢性心功能不全、高血压、房颤、感染等因素后,其依然与年龄独立相关(β=0.018,P=0.000);(3)NT-proBNP与左心房内径(β=0.044,P=0.000)、左心室质量指数(β=0.016,P=0.000)、左心室射血分数(β=-0.017,P=0.002)及E/A比值(β=-0.218,P=0.000)显著相关。结论在80岁以上的老年人中,NT-proBNP水平与多种疾病或非疾病因素相关,可以作为评价心脏结构和功能的指标。Objective To investigate how many factors will affect the serum N-terminal pro-B-type natriuretic peptide （NT-preBNP）level in the very elderly people （age≥ 80 years）. Methods 856 in-patients who excluded acute heart failure, acute myocardial infarction,coronary artery bypass graft and percutaneous transcoronary angioplasty last six months from Nov 2007 to Oct 2010 in geriatric cardiology department in the PLA general hospital were enrolled in this study. Medical history,measured height and weight of body were collected, both plasma marker （hemoglobin, blood glucose, serum total cholesterol, low density lipoprotein cholesterol, high density lipoprotein cholesterol,triglyceride, NT-proBNP）measurement and echocardiography were performed. Results A multiple linear regression analysis was done to determine the factors associated with the propeptide concentrations in very elderly population, NT-preBNP was mainly associated with chronic kidney disease （β = 0. 290, P = 0. 000 ）, chronic heart failure（β=0. 321 ,P = 0. 000）, hypertension （β = 0. 119,P = 0. 004）, atrial fibrillation （β = 0. 358,P = 0. 000）, pacemaker （β = 0. 231, P = 0. 001 ）, brain infarction （β= 0. 088, P = 0. 014 ）, infection （β = 0. 285, P = 0. 000 ） and anemia（β = - 0. 007 ,P = 0. 004 ）. Multiple regression analysis showed that NT-proBNP was related significantly with non-disease factors such as age （β = 0. 018, P = 0. 000 ） and BMI （β= - 0. 026, P = 0. 000 ）, the correlation was remain significantly after adjust chronic renal disease, chronic heart failure, hypertension, atrial fibrillation, postpacemaker, cerebral infarction, anemia and infection. Left atrial diameter （β= 0. 044, P = 0. 000 ） , left ventricular mass index（β = 0. 016, P = 0. 000）, left ventricular ejection fraction （β= - 0.017, P = 0. 002 ） and E/A raito （β = - 0. 218 ,P = 0. 000）was significantly correlated with serum NT-proBNP. Condusions Many factors, including non- diseases, such as age and BMI, an

关 键 词：老年人 80以上 利钠肽 脑 心力衰竭 

分 类 号：R541[医药卫生—心血管疾病]